[Comparison of vectorcardiography and echocardiography in the evaluation of the site and extent of necrosis in myocardial infarction without Q wave]. / Confrontation vectocardiographie-échocardiographie dans l'évaluation du siège et de l'étendue de la nécrose dans les infarctus myocardiques sans onde Q.

ABSTRACT

In order to improve the evaluation of the site and extent of the necrosis in acute myocardial infarction without Q wave (IMNQ), we used a multiparametric method taking into account the enzymatic values of the total CK, a score derived from Frank's VCG and a kinetic score of the VG segments estimated by echo-2D. The literature data have shown, according to the clinical and anatomical correlations, the frequency of the transmural lesions in the IMNQ cases and, on the contrary, of the lesions limited to the endocardial region and partially transmural in infarctions with new pathological Q waves. The heterogeneousness of the anatomo-pathological data can be explained by the mechanisms of the ischaemia, the site of the coronary occlusion, the presence or not of a spasm, the compensation by the collateral flux and eventually the effects of a treatment by fibrinolytic drugs.